Rectal carcinoid in a 30-year-old male: a review of current treatment options

Abstract

: Carcinoid tumors are neuroendocrine tumors that originate from enterochromaffin cells and primarily affect the gastrointestinal tract. They are commonly asymptomatic and found on routine screening colonoscopy. Histologically, these tumors stain positive for CD56, synaptophysin, or chromogranin A, which suggests their neuroendocrine origin. Approximately 20% of carcinoid tumors are found in the rectum. Once a rectal carcinoid is identified, it must be evaluated for the likelihood of metastasis in order to determine the course of treatment. We present a case report of a 30-year-old male with a carcinoid tumor of the rectum that was discovered on a follow-up colonoscopy performed after the patient was treated for sigmoid diverticulitis with a micro-perforation. Because carcinoid tumors are often identified on screening colonoscopy, it is not usually discovered in patients below the age of 50. This suggests that these slow growing tumors may exist in patients of younger age groups, but do not get officially diagnosed until they start getting screened. Our patient’s carcinoid tumor was removed via endoscopic mucosal resection, or EMR, however, there are many different options to consider when removing a rectal carcinoid, ranging from local endoscopic resection to radical surgical excision. This case report provides a review of EMR, the treatment used in our patient, and compares this technique to several other treatment options for rectal carcinoid removal.